By Ben White and Lindy Willmott
BMJ Blogs
Originally posted August 17, 2016
Here is an excerpt:
Compliance with the law was low with only 32% of doctors following the advance directive. Of interest was that doctors who knew the relevant law were more likely to comply with it and follow the advance directive than those doctors who did not know the law. Initially we thought that this could indicate that legal knowledge might lead to legal compliance. However, we then examined the reasons doctors gave for decision-making and also the factors they relied on to understand whether law was seen as important or not by doctors in their deliberations.
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So legally knowledgeable doctors are more likely to comply with the law – but law does not seem to be shaping decision-making in this area. This presented a puzzle to us. What else could be responsible for the association between doctors’ legal knowledge and compliance? More work is needed to fully understand what is happening here but we suggest that ethical considerations are a likely candidate. Both law and autonomy-focused ethics point to following the advance directive hence a decision motivated by this ethical orientation would also comply with the law. And medical ethics and law are also often taught together in an integrated way and so more legally-informed specialists are likely to have had more instruction in ethics too.
The blog post is here.
